Going to the Met Gala this year? No? Neither are we. But don’t feel too bad about it. While we’re sitting on our couches, drinking wine, eating macarons and live-tweeting the event in our pjs, the “lucky” ladies in attendance will be wearing dresses that are being compared to weighted vests.

That’s right, the glossy has gone ahead and shared their strategies on how to prepare your body for the seemingly emotionally and physically draining event. As they put it, the elaborate gowns “require a toned arm (slender but not too muscular, or it will throw off the whole look), a beautiful back (imperative for strapless or sweetheart necklines) and proper posture (slumping in a dress that took months to make just feels wrong).”

So how do they suggest you achieve this dress greatness? Tips include (but are not limited to) doing cardio every single day, engaging your abs at all times, and even beating the crap out of your floor using heavy, weighted ropes. “Attack the floor with them like the floor’s your worst enemy. You can vent your frustrations while combating upper arm jiggle and cinching and tightening your waist,” said celebrity trainer David Kirsch.

Look, we’re the first to admit that beauty is pain, and we’re all about a healthy workout routine. But we have a few questions, like:

How heavy could the dresses actually be?

Is there really an exact correct ratio of arm to dress?

Can Vogue replace our hardwood floors after we ruin them?

By engaging our abs at all times, do you mean sleeping too? That seems difficult.

We’ll have to wait until the gala to see if the ladies have taken this advice to heart, but something tells us they’re going to look pretty great no matter what.

There is increasingly talk about moving “upstream” to improve health and reduce health care costs, e.g., working to prevent disease before it happens by addressing the social and environmental determinants of health.

Among those championing this upstream approach is Rishi Manchanda, M.D. In his TED book, The Upstream Doctors, Manchanda argues for more “upstreamists” — physicians who see their work as including a “duty not only to prescribe a clinical remedy but to tackle sickness at its source.”

As an example of upstream medicine in practice, Manchanda recounts the story of a former patient, Veronica, who suffered from severe chronic headaches. Her interaction with the health care system had resulted in inconclusive medical tests and an expensive visit to the emergency room, but no answers as to the cause of her headaches, let alone a solution.

Manchanda took a different approach.

He used a questionnaire to identify risk factors in her daily life and discovered that Veronica was exposed to mold and cockroach allergens that could be the cause of her health issues. Instead of subjecting her to more medical tests, she was referred to a tenants’ rights group and received a follow up visit from a community health worker from his practice. In three months, Veronica was feeling better and her headaches subsided.

Moving Beyond the Individual Patient

Veronica’s story illustrates how clinicians can effectively address the social determinants of health by using tools that assess a patient’s community and environmental circumstances, as well as by including non-medical providers as part of a health care team. This approach is a necessary evolution in the practice of medicine that will improve patient care.

But that’s not the whole story.

Even if clinicians address the social factors that contribute to a patient’s poor health, they are still working at the individual level, treating disease person by person. “Upstream” clinicians can be more effective if they partner with the existing, very capable governmental public health system.

Extending the health care team to include nurse practitioners, physician assistants, and other non-clinical staff including benefits counselors, behavioral and mental health counselors, community health workers, and pharmacy technicians brings value to the individual patient. A partnership with the public health department, on the other hand, allows us to improve health for the whole community.

If the local public health department had been involved in Manchanda’s practice, many more than just Veronica could have benefited.

Coordinated Surveillance and Investigation

Veronica’s story represents one snapshot of life within a large, thriving, complex community. This individual information has tremendous potential to tell us about the community and its health if it can be aggregated across individual medical practices and health care systems.

Sharing these data with public health officials allows for analysis at the community level and can identify places where several individuals have the same problem. When disease clusters are identified, public health departments have experts trained in disease investigation that can pinpoint social and environmental risk factors and then develop strategies tailored to reduce the incidence and complexity of disease.

If health care providers in a community had been sharing information about patients with the local health department, public health officials might have found that Veronica was not alone and many others were experiencing similar health concerns. The public health department could then gather information about where these people were living, potential environmental triggers, the frequency of tenant complaints filed with the local housing authority, and other variables that could help us understand the cause of this common health issue.

Community-Level Strategies and Actions

When a health issue is caused by a shared social or environmental factor, the local health department can act at a community level. For example, local health departments can engage local media to raise awareness of the problem or develop public education campaigns. If you have ever seen a public service announcement about wearing a seat belt, washing your hands to prevent flu, or vaccinating against disease, you probably have your public health department to thank.

These public health messages can have an even greater impact when they are tailored to specific neighborhoods and coordinated with health care providers. As a government agency, the local health department has regulatory and statutory options, which it can leverage to change health policies and promote regulations that directly address the root causes of disease.

In Veronica’s case, involving the local health department may have led to every rental property owner in the city receiving a letter reiterating their responsibilities as landlords. The local health department could have engaged the local housing authority to improve the oversight, monitoring, and enforcement of existing regulations or determine if new regulations were needed to improve housing conditions. In extreme cases, the local public health department could condemn buildings or revoke a property owner’s ability to rent a property.

Medicine alone cannot fix problems that are rooted in social and environmental determinants of health.

The Upstream Doctors presents a vision for clinical medicine that recognizes that treating disease is not enough. Manchanda’s perspective on upstream health issues is a step forward in transforming how we see and respond to issues of health and disease in our communities, but the local health department should be included as a partner that is skilled in addressing the social determinants of disease and capable of community-level action.

Today’s health care problems are rooted in individual health choices shaped by the many contexts in which people live. Medicine and public health simply cannot afford to continue to work in their separate silos. Public health and primary care professionals must start to see their work as components of an integrated health system if we are to improve health across the board, from clinic to community.

In The Upstream Doctors, Manchanda retells an oft-cited parable of three friends who see children drowning in a river. Two rush into the water to save the children. The third friend swims upstream, acting to “stop whoever or whatever is throwing these children in the water.”

Here’s a different spin to this story. What if that third friend recalled meeting the people who lived upstream and called them? With that phone call, they quickly take action to find and stop the problem at its source.

Both upstreaming solutions work, but isn’t it more effective to communicate with each other and align our resources rather than starting a series of long, upstream swims?

Children significantly more likely to develop PTSD if mother afflicted

While fewer than 10 percent (8.4 percent) of the mothers were suffering from PTSD, more than a fifth (21 percent) of their children presented PTSD symptoms in a recent study on the topic. Children who developed PTSD symptoms also had more psychosomatic complaints such as constipation, diarrhea and headaches.

My first six months in recovery, it’s no exaggeration to say that I felt my mind expanding on a regular basis. Not only was I shocked that I didn’t actually have to ingest vats of cocaine up my nose every few days, but I was also astounded by the rules for living that I was suddenly being given.

I grew up in a house where my dad used to joke so often that the Golden Rule was that whoever makes the gold makes the rules, I never actually knew there was another Golden Rule. In short, I grew up believing that in order to be happy, you had to go to an Ivy League school, make six figures at your first job and sue people before they sued you. I had no idea that it was my self-absorption that was making me miserable, let alone that I had esteem issues and was angry to an almost un-live-able degree. Sitting in meetings, or just talking to people outside of them, I’d hear stuff that some could say was were nearly cliché-like in its simplicity but it made so much sense that I couldn’t help repeating it to nearly everyone I came into contact with. Some people didn’t get it — I already explained where I come from — but often those who did would think I was some sort of a genius (I’m reasonably certain I took credit at least some of the time). The expressions I got the most mileage out of were:

When you point a finger at someone, there are three pointing back at you.

I’ll never forget a guy named David saying this to me outside a meeting when I was maybe three months sober. I was complaining about someone — a skill I excel at, even today — when this guy who had what I thought then was a nearly unfathomable amount of sober time (five years, maybe?) casually offered up this chestnut as feedback. It was his way of saying that those things that enraged me the most about the object of my disdain were actually the exact same things I did when I was at my most egregious and that’s why I was so pissed off. (I did get a little hung up on trying to figure out where the fifth finger went, though.)

Resentment is like drinking poison and expecting someone else to die.

Oh, how this one blew my mind. I had spent a large portion of my life enraged at the various and sundry people I felt had wronged me (see above) and I truly, genuinely believed on a certain level that I was so powerful in my anger, my dirty looks and silent seething actually had an impact on them, rather than realizing it only made me look slightly unhinged. I thought I was protecting myself with all this anger, not realizing that the only one I hurt was me. This isn’t, of course, to say that I don’t occasionally still indulge in juicy resentments now and again.

I’m not much but I’m all I think about.

This one, and its stepsister, “I’m the piece of crap in the center of the universe,” was another one that stopped me in my tracks. Most of my life, my self-absorption had been off the charts and it was matched only by my self-loathing. And I didn’t have any idea until the day I heard this one and felt how much it resonated. Before recovery, I thought the world revolved around me but I also regularly told myself I was stupid and unlovable. Again, I’m much better now, but I still make some trips to the annex of self-obsession and self-hatred.

Expectations are resentments under construction.

Boy, were my expectations high back in the day — expectations of you mainly. This meant that I regularly wondered why I had such bad friends, horrible family members and terrible bosses. I basically decided that you were all going to do exactly what I felt you should and then felt incredibly hurt and resentful when you did not. And I had no idea I was writing scripts in my head for everyone to follow! I still have a hard time keeping my expectations low but I’m inspired by the most serene people I know, who seem to expect very little from other people and save a lot of time resenting them and expecting them to die.

Hang out in the barbershop long enough, and you’ll find yourself getting a haircut.

Okay I’ll admit that this is my least favorite of the five listed here, only because I think it sounds a little silly. But I’m wholly behind its message — which, to me, basically means that you’ll probably eventually drink if you bar hop with your old crowd, will have an urge for powder stimulants if you keep in touch with your dealer and will inevitably enter slacker-dom if you piss away your time with sad people who aren’t motivated. And also, of course, that your hair will surely come out shorter if you do a lot of time at the barbershop.

Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

Being from the great state of Wisconsin, I of course grew up consuming milk. No matter which meal of the day, milk was always offered as a beverage option. If you are able to digest dairy and enjoy the flavor, milk can play an important role in providing nutrition. Nonetheless, most nutrients found in milk are available from plenty of other sources. You can have a healthy diet with or without the consumption of milk. The health issue surrounding milk that I want to address is the process of adding four teaspoons of sugar to milk, while still calling it a “healthy” beverage for children. The main drawback with sweetened milk, commonly referred to as flavored milk, is that it sets the precedent for overly sweet foods.

During my two years of public service through FoodCorps teaching children nutrition education, I experienced firsthand the sweet palettes of modern kids. Items like blueberries and garden fresh tomatoes are now not sweet enough. This sugary preference was often a limitation for them appreciating the average sweetness of fruits and vegetables. Children are learning that this is how food should taste and anything unsweetened is not enjoyable.

If chocolate milk were promoted as a treat, I’d be less concerned. This however is not the case. Too many times, I have walked into a cafeteria and seen posters exclaiming the health benefits of sweetened milk. I would also be less worried if flavored milk was consumed in a context of an overall less sweetened diet. Unfortunately, sugary breakfast cereals, fruit juice, and fruit juice sweetened canned fruit are the current norm for school breakfast and lunch menus. Currently there are no set limits for the amount of sugar for school meals. On average, one 8oz sweetened carton of milk contains 4 teaspoons of added sugar. The consumption of one carton already exceeds the daily sugar allotment recommended for children by the American Heart Association.

The common argument you will hear is that without sweetened varieties kids would not drink milk. As I stated previously, a healthy diet may or may not include milk. Children do not need to consume milk to be healthy. Also, the underlying assumption of sweetened milk is the concept of adding sugar to food until a kid enjoys it. This is a flawed logic and is not preparing students to develop a life long healthy relationship with food.

I’m not arguing for nutrition perfectionism and I strongly believe in enjoying indulgent foods, however, sweetened milk is often consumed on a daily or a twice daily basis. I’m not naïve and have seen how much students prefer sweetened milk. Of all the milk consumed in schools, 71 percent of it is sweetened. I’ve also read the stories of kids revolting and other issues with the removal of sweetened milk. A recent Cornell University study found that the removal of sweetened milk from schools led to a 8 percent decrease in milk sales and 29 percent of non-sweetened milk to be thrown out. These issues are connected to social norms that start with schools and families, so let’s begin to realize that we have the power to change the precedent.

To start the transition to more health promoting social norms, it is important for nutrition programs to promote incremental change. School districts can begin by making sweetened milk less prevalent in the milk cooler and less accessible. School advertisements promoting flavored milk as a healthy choice should be removed. Parents and nutrition education can assist in the promotion of such beverages as treats rather than staples. School food operations can make sweetened milk a dessert and only offer it once a week.

Accordingly, as new generations of children begin school, the option to choose sweetened milk can be slowly limited. Students expect these products because we currently make it socially acceptable to consume them. Children learn our cultural norms and preferences, and currently we are telling them that food has to be overwhelmingly sweet, setting them up for a lifelong preference which could negatively impact their future health.

Two studies are shedding new light on the most common type of ‘friend’ to be unfriended on Facebook and their emotional responses to it. The studies show that the most likely person to be unfriended is a high school acquaintance. Both studies were based on a survey of 1,077 people conducted on Twitter.

Hip width and risk of birth-related trauma may play a role in a woman’s decision to have sex. Women who were more inclined to have one-night stands had wider hips, reveals a study into how a woman’s build influences her sexual behavior. Results of the study show that the number of sexual partners a woman had is largely driven by one-night stand behavior. This, in turn, correlates with a woman’s hip width and not waist-to-hip ratio. Overall, women in this study with hips wider than 14.2 inches had more sexual partners and more one-night stands than women with hips under 12.2 inches wide.